• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.186-191
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• 1994

Tc-99m MIBI, a lipophilic cation, was reported as a useful agent for localization of lung cancer. The effect of radiation therapy on the uptake of Tc-99m MIBI in lung cancer, however, was not well evaluated. The aim of the present study was to elucidate the usefulness of Tc-99m MIBI SPECT in the localization and the assessment of radiotherapy in non-small cell lung cancer. Twenty patients(19 males and 1 female, mean age 59, 16 squamous cell ca and 4 adenoca) were studied with Tc-99m MIBI SPECT before radiation therapy. Eleven patients(10 males and 1 female, mean age 59, 8 squamous cell ca and 3 adenoca) were repeated the study 1 month after the completion of radiation therapy(mean dose 6453cGy). All patients showed positive uptakes of Tc-99m MIBI in their tumors. One patient showed a hot uptake in atelectatic area. There was no difference of Tc-99m MIBI uptakes between squamous cell ca and adenoca either on planar or tomographic images. Tc-99m MIBI uptake ratios of squamous cell ca and adenoca were $1.50{\pm}0.16$ and $1.45{\pm}0.15$ on planar images, and $2.73{\pm}0.46$ and $2.54{\pm}0.37$ on tomographic images, respectively. The concordance between radiological change(chest x-ray and CT) and change of Tc-99m MIBI uptakes was 9/11 (81.8% ). In conclusion, Tc-99m MIBI SPECT was useful in the localization of tumor and the assessment of radiation therapy in non-small cell lung cancer.

• The Korean Journal of Nuclear Medicine
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• v.37 no.2
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• pp.120-127
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• 2003

Purpose: To evaluate diagnostic sensitivity of nuclear imaging in the detection of residual thyroid tissue and metastatic lesion, we have compared neck scintigrams with Tc-99m pertechnetate (Tc-99m scan) and high dose I-131 iodide (I-131 scan) in patients with differentiated thyroid cancer. Subjects and Methods: One hundred thirty-five thyroidectomized patients for differentiated thyroid cancer were enrolled in this study. Twenty-three had a previous history of radioiodine therapy. Planar and pin-hole images of anterior neck with Tc-99m were acquired at 20 minutes after injection, followed by I-131 scan three days after high-dose radioiodine therapy within 7 days interval. Patients were asked to discontinue thyroid hormone replacement more than 4 weeks. Results: All subjects were in hypothyroid state. Seventy out of 135 patients (51.9%) showed concordant findings between Tc-99m and I-131 scans. I-131 scan showed higher number of uptake foci in all of 65 patients showing discordant finding. Tc-99m scan showed no thyroid bed uptake in 34 patients, whereas 23 of them (67.6%) showed bed uptake in I-131 scan. Tc-99m scan did not show any uptake in thyroid bed in 11 of 112 patients without previous history of radioiodine therapy, but 9 of them showed bed uptake in I-131 scan. Tc-99m scan showed no bed uptake in all of the 23 patients with previous history of radioiodine therapy, in contrast 14 of them (60.9%) showed bed uptake in I-131 scan. Conclusion: These results suggest that Tc-99m scan has poor detectability for residual thyroid tissue or metastatic lesion in thyroidectomized differentiated thyroid cancer patients, compared to high dose I-131 therapy scan. Tc-99m scan could not detect any remnant tissue or metastatic lesion in patients with previous history of radioiodine treatment, especially.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.6
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• pp.546-552
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• 2007

Purpose: In the breast cancer patient, lymphatic mapping and sentinel lymph node biopsy are the most important procedure for axillary lymph node staging. We aimed to compare the three radiocolloids [$^{99m}Tc$-antimony trisulfide colloid (ASC), $^{99m}Tc$-tin colloid (TC), and $^{99m}Tc$-human serum albumin (HSA)] for sentinel lymph node mapping. Subjects and Methods: Totally, 397 patients with clinically N0 stage were enrolled. $^{99m}Tc$-ASC was injected in 202 out of 397 patients, $^{99m}Tc$-TC was injected in 120 patients, and $^{99m}Tc$-HSA was injected in the remaining 75 patients. The sentinel lymph nodes were localized by lymphoscintigraphy and selected using intraoperative gamma probe. All sentinel lymph nodes were investigated by intraoperative pathologic consultation. The axillary lymph nodes which were harvested by the lymph node dissection were also investigated. Results: The patients of each group showed similar clinical characteristics. There were no significant differences (p>0.05) in the identification rate of sentinel lymph nodes (IR), false negative rate (FNR), and negative predictive value (NPV). The axillary lymphadenectomy revealed axillary lymph node metastases in those three groups (ASC-33.2%, TC-31.7%, HSA-22.7%). The IR, FNR, and NPV were not significantly different among those groups. Conclusion: Those three $^{99m}Tc$-labeled radiocolloids showed equivalent results in sentinel lymph node mapping of breast cancer.

• Journal of Microbiology and Biotechnology
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• v.18 no.9
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• pp.1599-1605
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• 2008

Biodistribution and lymphoscintigraphy of cyclosporine A (CyA) and technetium-99m ($^{99m}Tc$) were studied using ${^99m}Tc$-labeled dextran acetate (DxA) including CyA. DxA particles were prepared from dextran with acetic anhydride, and CyA was loaded into them. Lymphatic delivery of ${^99m}Tc$-labeled DxA particles containing CyA was evaluated after subcutaneous injection into the foot pad of rats and compared with those of ${^99m}Tc$-labeled human serum albumin (HSA). The labeling efficiency of CyA-loaded ${^99m}Tc$-DxA particles was about 95% at 30 min. The labeling efficiency maintained stably above 80% for 12 h. The percent injected dose (%ID) of CyA-loaded ${^99m}Tc$-DxA was similar to that of ${^99m}Tc$-HSA at the inguinal lymph node after 40 min. The CyA-loaded ${^99m}Tc$-DxA could be as well distributed as ${^99m}Tc$-HSA through the lymph node. The DxA particles could steadily distribute the CyA as well as the ${^99m}Tc$ radiolabeling through the lymph node.

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.720-727
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• 1996

Objectives: $^{201}TI$ - chloride, $^{99m}Tc$ - MIBI, $^{99m}Tc$(V) - DMSA SPECT has been used in distinguishing lung cancer from benign lesion. To compare the diagnostic efficacy of SPECT with these tumor - seeking agents, we perfonned three consecutive SPECT using $^{201}TI$, $^{99m}Tc$ - MIBI, $^{99m}Tc$(V) - DMSA in same subjects with a solitary pulmonary lesion. Methods: SPECT was carried out at 10min and 3hr for $^{201}TI$ after injection of 20mCi, and 2hr for $^{99m}Tc$ - MIBI and $^{99m}Tc$(V) - DMSA after injection of 20mCi, respectively, in 37 patients with a solitary pulmonary lesion(27 lung cancer and 10 benign diseases). In patients showing visual uptake on lesion site, we obtained the lesion - to - background(target lesion/contralateral normal lung) uptake ratio from transverse slice for each radionuclide and also calculated the retention index for $^{201}TI$. Results: The diagnostic sensitivity of $^{201}TI$, $^{99m}Tc$ - MIBI and $^{99m}Tc$(V) - DMSA SPECT to lung cancer was 100%, 96% and 73%, and the specificity was 40%, 70% and 70%, respectively. The low specificities for these agents were mainly due to high positive uptake in patients with active pulmonary tuberculosis. There were no significant differences in uptake ratios and retention index between malignant and benign lesions, and among the histologic types of lung cancer. Conclusion : $^{201}TI$ and $^{99m}Tc$ - MIBI showed higher sensitivity than $^{99m}Tc$(V) - DMSA for detecting lung cancer, but was of limited usefulness in distinguishing lung cancer from benign lesion due to low specificity, especially in area with a high prevalence of active pulmonary tuberculosis.

• The Korean Journal of Nuclear Medicine
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• v.30 no.3
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• pp.367-371
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• 1996

The $MAG_3$ is a tubular excreting radiopharmaceutical for renal image. We synthesized benzoyl $MAG_3\;(Bz-MAG_3)$ and made a kit for labeling with $^{99m}Tc$. We checked the labeling efficieny of $^{99m}Tc$ labeled $MAG_3$ and biodistribution. Labeling efficieny was checked by TLC-SG (acetonitrile/$H_2O$=2/1). After injecting of 1 mCi of $^{99m}Tc-MAG_3$ to ICR-mice, $T_{max}(min),\;T_{1/2}(min)$ were obtained in the renogram. Sequential images (30sec, 2min, 5min, 10min, 15min, 20min) of $^{99m}Tc-MAG_3$ were compared with those of commercial $^{99m}Tc$-DTPA (Du Pont Merck Pharmaceutical Co.) kit. 1) The $R_f$ value of synthesized $^{99m}Tc-MAG_3$ was 0.78 and labeling efficiency was $97.5{\pm}1.9%$ (n=10). 2) The dynamic images of the $^{99m}Tc-MAG_3$ were better than those of the $^{99m}Tc$-DTPA. 3) The $T_{max}(min.)$ and $T_{1/2}(min.)$ of $^{99m}Tc-MAG_3$ (n=10) were $1.5{\pm}0.5$ (left), $1.4{\pm}0.4$ (right), and $4.3{\pm}1.4$ (left), $4.8{\pm}2.0$ (right), respectively. The $T_{max}(min.)$ and $T_{1/2}(min.)$ of $^{99m}Tc$-DTPA (n=7) were $2.7{\pm}1.6$ (left), $2.7{\pm}1.6$ (right), and $3.8{\pm}1.7$ (left), $4.5{\pm}2.7$ (right), respectively. The quaility of image and labeling efficiency of the synthesized $Bz-MAG_3$ kit were excellent, that it was supposed to be used in routine clinical work.

• Progress in Medical Physics
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• v.19 no.1
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• pp.1-8
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• 2008

Technisium $(^{99m}Tc)$ is one of the most widely used radioactive isotopes for diagnosis in nuclear medicine. In general, technisium is produced inside the so called $^{99m}Tc$ generator which is usually made out of lead to shield relatively high energy radiation from $^{99}Mo$ and its daughter nuclide $^{99m}Tc$. In this paper, a GEANT4 simulation is carried out to test the safety of the $^{99m}Tc$ generator, taking the Daiichi product with radioactivity of 500 mCi as an example. According to the domestic regulation on radiation safety, the dose at 10 cm and 100 cm away from the surface of shielding container should not exceed 2.0 mSv/h and 0.02 mSv/h, respectively. The simulated dose turned out to be less than the limit, satisfying the domestic regulation.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.1-7
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• 1996

PURPOSE : The purpose of this study is to know the ability of detecting malignant tumor tissue by Tl-201 scan, and to compare with that of Tc-99m-MIBI and Tc-99m-MDP scan. MATERIAL AND METHODS : Between February 1994 and December 1995,38 unselected patients with various bone pathologies were studied prospectively. Eighteen had malignant bone and soft tissue pathologies, while twenty had benign. All patients were studied with Tl-201, Tc-99mMIBI and Tc-99m-MDP scan prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator was used for scanning. To avoid the interaction of isotope, the early(30min.) and delayed phase(3hrs.) of Tl-20l scan was performed first and Tc-99m-MIBI scan was performed after 30 minutes, and then Tc-99m-MDP scan 48 hours later. The scan images were visually evaluated by a blinded nuclear medicine physician. We could find true positive, true negative, false positive and false negative by the comparison of results with those of biopsy. We calculated positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%) of each scan. RESULT : The results of each scan were 85.7, 100, 100, 85, 92.1% in Tl-201, 81, 94.1, 94.4, 80, 86.8% in Tc-99m-MIBI and 50, 66.7, 88.9, 20, 52.6% in Tc-99m-MDP scan. As a conclusion, Tl-201 scan was the most specific and accurate method for detecting malignant tumor tissue. Tc-99m-MIBI scan was also good for malignant tumor searching. CONCLUSION : With our results, we can use Tl-201 scan to differentiate benign from malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

• The Korean Journal of Nuclear Medicine
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• v.33 no.2
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• pp.152-162
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• 1999

Purpose: To determine whether $^{99m}Tc$-MIBI is recognized by the multidrug resistant P-glycoprotein (Pgp), we have measured quantitatively $^{99m}Tc$-MIBI uptake in cancer cells. The effects of various Pgp reversing agents on cellular $^{99m}Tc$-MIBI uptake were also investigated in the presence of multidrug resistance gene-1 (mdr1 gene) overexpression. Materials and Methods: We measured percentage uptake of $^{99m}Tc$-MIBI at different incubation temperatures both in mdr1 positive and negative cells. The effects of verapamil, cyclosporin, and dipyridamole on cellular uptake of $^{99m}Tc$-MIBI were also evaluated with or without overex-pression of mdr1 gene in cultured murine leukemia Ll210 cells. Results: The mdr1 gene expressing cell lines were effectively induced in in vitro with continuous application of low-dose adriamycin or vincristine. Cellular uptake of $^{99m}Tc$-MIBI was higher in mdr1 negative Ll210 cells than those of mdr1 positive cells, and higher when incubated in $37^{\circ}C$ than $4^{\circ}C$. In the presence of verapamil, cyclosporin or dipyridamole, $^{99m}Tc$-MIBI uptake was increased upto 604% in mdr1 positive cells. Conclusion: Cellular uptake of $^{99m}Tc$-MIBI is lower in leukemia cells over-expressing mdr1 gene, and MBR-reversing agents increase cellular uptake. These results suggest that $^{99m}Tc$-MIBI can be used for characterizing Pgp expression and developing MDR-reversing agents in vitro.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.3 no.1
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• pp.38-43
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• 2017

Tc-99m labeled sestamibi ($^{99m}Tc$-MIBI) is one of most widely used radiopharmaceuticals for myocardial SPECT imaging. Radiolabeling of $^{99m}Tc$-MIBI is recommended by heating in $100^{\circ}C$ water bath for 15 min. However, the water bath might be a source of contamination. Thus, if radiolabeling of $^{99m}Tc$-sestamibi can be performed at room temperature, then it would be more convenient to use in clinical application. In this study, we performed the radiolabeling of $^{99m}Tc$-MIBI in different temperature conditions or using different instruments to find out the efficient labeling condition. We studied the $^{99m}Tc$-MIBI labeling at room temperature or $100^{\circ}C$ heating block, and checked the labelling yields every 1 min for 10 min using radio-TLC with 2 different eluents-saline and acetone. From the experiment, we confirmed that the $^{99m}Tc$-MIBI can be labeled over 90% yield but not completed at room temperature. However, the $^{99m}Tc$-MIBI labeling was completed when it was performed in the $100^{\circ}C$ heating block. Finally, we proved that heating is essential for complete $^{99m}Tc$-MIBI labelling, furthermore using heating block is also possible instead of water bath.